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目的:探讨低管电压间接法下肢CT静脉成像(CTV)在静脉曲张术前评价的临床价值研究。材料和方法:本研究通过医院伦理委员会批准。55名疑诊为下肢静脉曲张患者(F/M,23/32,年龄范围15~77岁)纳入本研究。所有患者均行下肢CTV,将原始图像进行MPR和VR重建,对图像质量评价。客观评价指标为大隐静脉(GSV)和曲张静脉(VV)的信号强度(SI),信噪比(SNR)和对比噪声比(CNR)。主观评分由2名放射科医师阅片评价,并记录直径大于2 mm的交通静脉和最终辐射剂量。结果:44名患者(F/M,17/27,年龄范围36~67岁)诊断为下肢静脉曲张,其中单侧31名,双侧13名,其他患者中2名诊断为动静脉瘘,3名诊断为静脉发育不全,6名诊断为下肢静脉血栓。所有44名下肢静脉曲张患者的GSV全程显示,GSV近端与VV的客观评价指标比较无统计学差异,平均SI、SNR、和CNR分别为((122±16.4)HU Versus(125.9±23.6)HU),(9.62±2.71 Versus 9.91±3.12),(4.08±2.39 Versus 4.36±2.81),主观评价指标中,图像质量好35例(79.5%),一般8例,差1例(2.3%)。共22支交通静脉被检出,平均直径为(3.21±0.87)mm,并在后续手术中证实。平均辐射剂量(804.7±96.7)mGy·cm。结论:低管电压迭代重建间接法下肢CTV在静脉曲张的应用中,能够以较好的图像质量显示静脉回流路径,并检出交通静脉,有助于术前更完善的评价。
Objective: To investigate the clinical value of low voltage voltage indirect CT venography in lower extremity in varicose veins preoperative evaluation. Materials and Methods: This study was approved by the Hospital Ethics Committee. Fifty-five patients with suspected varicose veins (F / M, 23 of 32, age range 15 to 77 years) were included in this study. All patients underwent lower extremity CTV, the original image MPR and VR reconstruction, the image quality evaluation. The objective evaluation indicators are the signal intensity (SI), signal to noise ratio (SNR) and contrast to noise ratio (CNR) of saphenous vein (GSV) and varicose veins (VV). Subjective ratings were reviewed by 2 radiologists and traffic veins and final radiation doses greater than 2 mm in diameter were recorded. Results: Forty-four patients (F / M, 17/27, age range, 36-67 years) were diagnosed as varicose veins of lower extremity, with 31 unilateral and 13 bilateral. Two of the other patients were diagnosed as arteriovenous fistula, 3 The diagnosis of venous hypoplasia, 6 were diagnosed as venous thrombosis. All 44 patients with varicose veins of the GSV whole journey showed that there was no significant difference in the objective evaluation index between the proximal GSV and VV. The mean SI, SNR, and CNR were (122 ± 16.4) HU Versus (125.9 ± 23.6) HU ), (9.62 ± 2.71 Versus 9.91 ± 3.12) and (4.08 ± 2.39 Versus 4.36 ± 2.81), respectively. Among the subjective evaluation indexes, the image quality was good in 35 cases (79.5%), fair in 8 cases and poor in 1 case (2.3%). A total of 22 traffic veins were detected with an average diameter of (3.21 ± 0.87) mm, and confirmed in follow-up surgery. The average radiation dose (804.7 ± 96.7) mGy · cm. CONCLUSIONS: LVTV indirect reconstruction method in the lower extremity CTV can display venous return path with good image quality and detect the traffic vein in the application of varicose veins, which is helpful for the preoperative evaluation.